Anthem Blue Cross Blue Shield of California policy
LAB.00050 Metagenomic Sequencing for Infectious Disease in the Outpatient Setting
LAB.00050 Metagenomic Sequencing for Infectious Disease in the Outpatient Setting is a public Anthem Blue Cross Blue Shield of California policy (policy LAB.00050). It lists 8 CPT or HCPCS codes, 6 of them on the Anthem Blue Cross Blue Shield of California prior authorization list. Not a coverage decision; the payer's own document governs.
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- Policy number
- LAB.00050
- Line of business
- Commercial
- Source
- www.anthem.com
Codes in this policy
The CPT and HCPCS codes the policy names. A policy can name a code it excludes. Prior authorization status is from the Anthem Blue Cross Blue Shield of California prior authorization list.
| Code | Prior authorization | Description on the prior authorization list | Other Anthem Blue Cross Blue Shield of California policies |
|---|---|---|---|
| 0112U | On the list | Infectious agent detection and identification, targeted sequence analysis (16S and 18S rRNA genes) with drug- resistance gene | Policies naming 0112U |
| 0152U | On the list | Infectious disease (bacteria, fungi, parasites, and DNA viruses), DNA, plasma, untargeted next-generation sequencing, report for significant positive pathogens | Policies naming 0152U |
| 0323U | On the list | Infectious agent detection by nucleic acid (DNA and RNA), central nervous system pathogen, metagenomic next- generation sequencing, cerebrospinal fluid (CSF), identification of pathogenic bacteria, viruses, parasites, or fungi | Policies naming 0323U |
| 0480U | On the list | Infectious disease (bacteria, viruses, fungi, and parasites), cerebrospinal fluid (CSF), metagenomic next-generation sequencing (DNA and RNA), bioinformatic analysis, with positive pathogen identification | Policies naming 0480U |
| 0531U | Not listed | Policies naming 0531U | |
| 0600U | On the list | Infectious disease (wound infection), identification of 65 organisms and 30 antibiotic resistance genes, wound swab, real-time PCR, reported as positive or negative for each organism | Policies naming 0600U |
| 0666U | Not listed | Policies naming 0666U | |
| 87999 | On the list | Unlisted microbiology procedure [when specified as in vitro chemosensitivity or in vitro chemoresistance assay] or [when specified as a pooled antibiotic sensitivity test with multiplex PCR, such as the Guidance® UTI test] | Policies naming 87999 |
All Anthem Blue Cross Blue Shield of California policies · Anthem Blue Cross Blue Shield of California prior authorization CPT list